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Sutherlandia frutescens

Scientific Name
Sutherlandia frutescens, Lessertia frutescens
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Clinical Summary

Sutherlandia frutescens is a shrub native to South Africa and the coast of West Africa. This plant and related species have been used by the locals as medicine to treat diabetes, chicken pox, and external wounds. Although Sutherlandia is not generally consumed as a dietary supplement in the West, some use the raw herb as an adaptogen. Constituents in Sutherlandia have antiviral, antibacterial, antifungal and anticancer properties (2). Sutherlandia is also known as “Cancer bush” for its purported use as a cancer treatment. There are case reports of Sutherlandia's ability to reduce fatigue in cancer patients (3).

In recent years, there is a growing effort in Africa to promote the use of local herbs to treat AIDS due to the lack of pharmaceuticals but easy access to traditional medicines. Based on reports that Sutherlandia is effective against HIV virus (4), it has been proposed as a treatment for AIDS (5). A study is currently underway to test the safety and efficacy of this herb in HIV-infected adults (6).
Adverse effects are rare but Sutherlandia may inhibit P-glycoprotein and cytochrome P450 3A4 and can interact with other substrate drugs, particularly those used to treat AIDS (7) (8).

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Food Sources
  • Sutherlandia frutescens is generally consumed as a tea.
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Purported Uses
  • Prevent infection
  • As tonic
  • Stomach and blood ailments
  • Cancer
  • AIDS
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Constituents
  • L-canavanine, L-arginine, Pinitol, GABA and Triterpenoid Glucoside
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Mechanism of Action

Sutherlandia was shown to have antioxidant and anti-inflammatory effects in vitro (9). The active components of the plant are L-canavanine, Pinitol, GABA, and novel triterpenoid glucoside. Pinitol demonstrates antidiabetic effects by increasing the availability of glucose for cell metabolism (2). GABA found in dry leaves of Sutherlandia can slow down nerve cell activity (2).
The ethanolic extract of Sutherlandia inhibits growth of MCF-7 breast adenocarcinoma cell line by inducing apoptosis (10) (11). Sutherlandia downregulates metalloproteinases (MMP) that control cell migration, proliferation, apoptosis, and regulate tumor expansion, angiogenesis and dissemination (10).

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Contraindications
  • Pregnant women should not take Sutherlandia frutescens.
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Adverse Reactions

Common: Diarrhea, dry mouth, dizziness.
Rare: Drinking or swallowing high doses of Sutherlandia may cause sweating and vomiting (2).

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Herb-Drug Interactions
  • Cytochrome P450 substrates: Sutherlandia inhibits CYP3A4 and can affect the intracellular concentration of drugs including antiretroviral treatments metabolized by this enzyme (7).
  • P-Glycoprotein substrates: Sutherlandia was shown to inhibit P-Gp activity and can interfere with the metabolism of drugs including antiretroviral treatments (8).
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Literature Summary and Critique

Johnson Q, Syce J, Nell H, et al. A randomized, double-blind, placebo-controlled trial of Lessertia frutescens in healthy adults. PLoS Clin Trials. 2007;2(4):e16.
This is the first clinical trial of Sutherlandia conducted to determine its toxicity and hemotological effects. Twenty-five healthy adults were randomized to consume either Sutherlandia leaf powder 800mg daily or a placebo. After 3 months, the Sutherlandia group reported better appetite. No other clinically significant differences were found between the two groups.
Further studies are needed to determine the efficacy of Sutherlandia products.

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References
  1. Sutherlandia. http://www.sutherlandia.org/literature.html. Accessed September 10, 2011.
  2. van Wyk BE, Albrecht C. A review of the taxonomy, ethnobotany, chemistry and pharmacology of Sutherlandia frutescens (Fabaceae).J Ethnopharmacol. Oct 28 2008;119(3):620-629.
  3. Grandi M RL, Vernay M. Lessertia (Sutherlandia frutescens) and fatigue during cancer treatment. Phytotherapie. 2005;3:110.
  4. Harnett SM, Oosthuizen V, van de Venter M. Anti-HIV activities of organic and aqueous extracts of Sutherlandia frutescens and Lobostemon trigonus. J Ethnopharmacol. Jan 4 2005;96(1-2):113-119.
  5. Morris K. Treating HIV in South Africa—a tale of two systems. Lancet. Apr 14 2001;357(9263):1190.
  6. A Controlled Study of the Safety and Efficacy of Lessertia Frutescens in HIV-infected South African Adults. http://www.clinicaltrials.gov. Accessed September 10, 2011.
  7. Mills E, Foster BC, van Heeswijk R, et al. Impact of African herbal medicines on antiretroviral metabolism. AIDS. Jan 3 2005;19(1):95-97.
  8. Brown L, Heyneke O, Brown D, van Wyk JP, Hamman JH. Impact of traditional medicinal plant extracts on antiretroviral drug absorption. J Ethnopharmacol. Oct 28 2008;119(3):588-592.
  9. Fernandes AC, Cromarty AD, Albrecht C, van Rensburg CE. The antioxidant potential of Sutherlandia frutescens. J Ethnopharmacol. Nov 2004;95(1):1-5.
  10. Stander BA, Marais S, Steynberg TJ, et al. Influence of Sutherlandia frutescens extracts on cell numbers, morphology and gene expression in MCF-7 cells. J Ethnopharmacol. Jun 13 2007;112(2):312-318.
  11. Stander A, Marais S, Stivaktas V, et al. In vitro effects of Sutherlandia frutescens water extracts on cell numbers, morphology, cell cycle progression and cell death in a tumorigenic and a non-tumorigenic epithelial breast cell line. J Ethnopharmacol. Jul 6 2009;124(1):45-60.
  12. Chinkwo KA. Sutherlandia frutescens extracts can induce apoptosis in cultured carcinoma cells. J Ethnopharmacol. Apr 8 2005;98(1-2):163-170.
  13. Johnson Q, Syce J, Nell H, Rudeen K, Folk WR. A randomized, double-blind, placebo-controlled trial of Lessertia frutescens in healthy adults. PLoS Clin Trials. 2007;2(4):e16.
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How It Works

Bottom line: Laboratory studies indicate anticancer effects of Sutherlandia frutescens, but it has not been shown to treat or prevent cancer in humans.

Sutherlandia frutescens is a shrub native to Southern Africa and along the coast of West Africa. It is used in traditional medicine to treat diabetes, chicken pox, and external wounds, and also as a cancer treatment. Laboratory studies show that Sutherlandia can fight off viruses, bacteria, fungi, and also has anticancer properties. A few case reports show that it can decrease fatigue in cancer patients.
Because Sutherlandia can fight HIV virus, it is being proposed as an AIDS treatment in Africa. Clinical trials are needed to determine Sutherlandia's safety and efficacy.

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Purported Uses
  • Prevent infections
    Laboratory studies show that Sutherlandia has antibacterial, antiviral, and antifungal effects. Human studies are needed.
  • Stomach and blood ailments
    There is no scientific evidence to support this claim.
  • Cancer
    Sutherlandia showed anticancer effects in lab studies, but it has not been studied in cancer patients.
  • AIDS
    Laboratory studies indicate that Sutherlandia has antiviral properties, but human data are needed.
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Do Not Take If
  • You are pregnant.
  • You are taking drugs that are substrates of Cytochrome P450 3A4 (Sutherlandia may increase the risk of side effects of these drugs).
  • You are taking drugs that are substrates of P-Glycoprotein (Sutherlandia may increase the risk of side effects of these drugs).
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Side Effects

Common: Diarrhea, dry mouth, dizziness.
Rare: Drinking or swallowing high doses of Sutherlandia may cause sweating and vomiting.

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Dosage (Inside MSKCC Only)
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Aliases
Cancer Bush
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Last updated: March 26, 2012
E-mail your questions and comments to aboutherbs@mskcc.org.